7 days ago
Hospices faked patients' terminal illnesses for Medicare fraud: DOJ
Two West Covina women are facing federal charges for allegedly defrauding Medicare out of millions and paying kickbacks to those who could procure them more patients for the scheme.
Normita Sierra, the 71-year-old owner of two hospices in West Covina, allegedly 'filed more than $4.8 million in false and fraudulent claims to Medicare – which paid more than $3.8 million on those claims – for medically unnecessary services for people not terminally ill,' the U.S. Department of Justice said in a news release.
Sierra (aka 'Normie') faces nine counts of health care fraud, four counts of illegal remuneration for health care referrals and a count of conspiracy.
Additionally, 55-year-old Rowena Elegado (aka 'Weng') faces the illegal remuneration and conspiracy counts.
Prosecutors say Sierra's Golden Meadows Hospice Inc. and D'Alexandria Hospice Inc. billed Medicare for hospice services for patients who weren't terminally ill between September 2018 and October 2022.
Sierra and Elegado allegedly worked together to pay kickbacks of up to $1,300 per patient per month to recruiters who brought patients to the hospices despite 'knowing that most of those patients had not been referred by their primary care physicians for such services,' the DOJ said.
Prosecutors identified two others who've already pleaded guilty to their roles in the scheme:
Carl Bernardo, a 53-year-old Chino resident who pleaded guilty in September to one count of accepting kickbacks and who will be sentenced on Oct. 23
Relyndo Salcedo, a 60-year-old nurse practitioner from Fontana who pleaded guilty in May to one count of health care fraud and whose sentencing is set for Nov. 20
Salcedo initially assessed potential patients for the hospice and found many ineligible, but Sierra 'made the ultimate enrollment decisions.' Sierra and Bernardo put pressure on Salcedo, who 'exaggerated and falsified the patients' conditions to make them seem terminally ill,' prosecutor said.
'Hospice physicians then relied on Salcedo's records to certify the patients as hospice appropriate,' the release explained. 'Once enrolled, those patients – who were not in fact terminally ill – rarely died, and instead were often discharged at around six months at Sierra's direction, sometimes to her home health company or the other hospice company.'
Sierra and Elegado will be arraigned Tuesday afternoon in U.S. District Court in downtown Los Angeles.
If convicted, each count of health care fraud or illegal kickback carries a maximum sentence of 10 years in federal prison, while conspiracy carries a sentence of up to five years.
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